Thinking of leaving the NHS? Be honest with your team

communicate with your team about leaving the NHS

What are some of the important things a practice owner needs to consider with regard to their team when deciding to hand back an NHS contract? Zoe Close caught up with Sarah Buxton to get some helpful pointers.

Zoe Close (ZC): There are occasions when we’re working with a practice when the owner has made the decision to leave the NHS, and they know exactly what they’re doing and why they’ve chosen to do it. However, sometimes we find ourselves in a situation where they haven’t shared their vision with their team. If this is the case, we always advise them to take the time make sure everyone in the team understands what’s happening.

The conversions that work best are ones where the whole team has been involved and everyone is on board. There have been discussions about what is happening when. Everyone is clear on how they’re going to respond to any questions from patients about the change. What other things do you advise they consider, Sarah?

Explain your vision

Sarah Buxton (SB): What people in these circumstances have to bear in mind is that about 62% or around two thirds of their workforce will not like change. That could apply to a small change within the practice or to something that they themselves perceive to be a larger change. Whichever it is, they will see it as something that will affect them either personally or financially, such as giving up an NHS dentistry contract.

So, it’s important that you have a strategy and a vision. It’s important to explain to them what your vision and plan is. Be open and honest about why you’re doing it.

What I sometimes find in practice is that the workforce don’t understand what a practice owner goes through. They aren’t aware of the financials. They don’t know that it can be quite difficult to run a business on NHS income. For example, I have a client in Wales who is losing money, but he is holding onto the NHS contract as he feels he has to keep it. But that’s his heart, not his commercial head speaking. However, his staff may not know that he’s losing money and it’s not working for him.

So, I would say be honest with your team and share your vision and strategy. Explain your reasons as to why you’re making the change and communicate these in a positive way.


SB: Remember people need to receive communication in different ways. Some people like one-to-one meetings, others prefer group meetings, while some will want things to be given to them in a written format. So, communicate with your team members in the way you know they prefer.

Tell them what you’re doing but be aware that some people might be shocked or angered. They may misunderstand, or they might have anxiety about the changes. So be prepared for their reaction. Be aware that they may not have the same feelings that you are having of ‘Great! We’re giving up NHS dentistry.’

However, what I’m finding is that there are a lot of team members who are actively in favour of leaving NHS dentistry. They want it for their practice because they’d like to work in a different way. There are a lot of stresses for the team involved in reaching NHS targets. So, they might be really happy about the change and it’s important to acknowledge their feelings too.

Addressing concerns

SB: However, they will probably still have questions so you will need to work with them and try and answer as many of their concerns as you can.

I feel it’s important to make the point that, depending on how your contracts are drawn up, you are going to have to look at serving notice and changing contracts. However, I wouldn’t broach that subject first of all! Do the part that involves soft skills first. Deal with the communication, and then once you’ve done that, cover the legal implications.

You won’t be carrying on with UDA targets for your associates so that will require a contractual change. If you have a limited company and an NHS contract running outside the limited company, it may be that previously you’ve been seconding your staff out to work on the NHS dentistry so that will also require a change to their contract.

So, some contractual changes will be needed, but you don’t want to worry your staff about that at first. The key at the outset is making sure that you communicate with them.

ZC: I do think this is an aspect of NHS conversions that we don’t speak about enough in practice. We assume that this is something that would happen automatically. However, with everything that’s going on when you’re in the middle of a conversion, it’s probably something that can get overlooked quite easily.

Nonetheless, it’s really important that time is put aside to make sure everyone in the existing team has been spoken to and understands exactly what is going to happen and where they stand.

Supporting the transition

SB: I agree. I think it’s one of the most important things to consider. Because if you are moving to a plan provider like Practice Plan, I know you get lots of support with the mechanics of the transition. So, at that level it is very supported, and it can be streamlined and quite easy to do.

However, when it comes to the team, you will have lots of different personalities to deal with when you’re communicating the change to them and it’s not always easy to predict how they will react or whether they will understand fully.

I would say communication is probably the most important element of giving up NHS dentistry. Making sure that your workforce is happy and that they understand what’s happening. However, I really am finding in practice that the staff are quite happy about it. And it’s easier to recruit self-employed staff because they want to work in private dentistry.

So, there are lots of advantages to it, but we do need to make sure that we communicate in the right way, and the right way is being honest and transparent about things, acknowledging your team members’ feelings and answering any questions they may have.

ZC: Sound advice, Sarah. Thank you.

If you’re considering your options away from the NHS and are looking for a provider who will hold your hand through the process whilst moving at a pace that’s right for you, why not start the conversation with Practice Plan on 01691 684165, or book your one-to-one NHS to private call today:

For more information visit the Practice Plan website:

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